By Ellen Thompson/Havre Daily News/ethompson@havredailynews.com
When the Hill County flu vaccination clinic began Tuesday at 10 a.m., there was a line of people waiting for the doors to open. But what began with a pour ended with a trickle. Of the 1,026 doses given Tuesday, a quarter of those were administered in the first 1 hours of the 10-hour day, county nurse and clinic organizer Cindy Smith said.
The clinic, which ends at 5 p.m. today, is being held at the District IV Human Resources Development Council building on Fifth Avenue. About 2,400 adult doses and 300 pediatric doses were available for today's clinic.
Organizers had planned to split the clinic's 3,448 total doses between two days, Smith said. Tuesday afternoon they realized that the demand was not as great as expected. Effective 5 p.m. Tuesday, all seniors over the age of 65 were invited to get a vaccination, rather than only those seniors with an underlying illness, she said.
"We just didn't know how many people over the age of 65 had underlying illnesses," Hill County Health Department employee Jennifer Brandon said, explaining the department's reasoning for its original criteria.
She added that because Hill County has a high population of people over 65, the clinic would not change its criteria again. The Health Department has ordered 140 doses of flu mist, a nasal spray vaccine, which can only be given to healthy adults. Twenty people have signed up to receive a dose. Those vaccinations will be given by appointment through the health department.
Other priority groups include children ages 6 to 23 months, persons ages 2 to 64 with underlying chronic medical conditions, women who are pregnant during the influenza season, children ages 6 months to 18 years on chronic aspirin therapy, day-care providers of children younger than 6 months of age, parents and household contacts of children younger than 6 months of age, and health care workers involved in direct patient care.
Hill County first began planning for the two-day clinic in September. The goal was to vaccinate as many Hill County residents as possible. But on Oct. 5, Hill County, along with the rest of the nation, learned that America's second-largest supplier of flu vaccine, Chiron Corp., was suspended from distributing its doses because of problems with the company's plant in Liverpool, England. That news forced Hill County to adjust its plan for the clinic, directing it towards the highest-risk populations.
Havre resident Carol Plenninger visited the clinic twice Tuesday, witnessing the fall-off in turnout firsthand. Plenninger came first at 9:45 a.m., before the doors opened. She said she planned to vaccinate herself and her 6-month-old twins. She said she waited 1 hours to receive a vaccination.
Later in the day, Plenninger returned with her 3-year-old and 6-year-old boys. Plenninger said her sons didn't have to wait to be vaccinated.
The Centers for Disease Control and Prevention recommends that for families with young babies, the entire household should be inoculated. Plenninger explained to her son Cameron, the 3-year-old, that he needed the shot to help make sure his baby brother and sister, the twins, don't get sick. Cameron said that he doesn't like shots.
Dixie Cooper arrived shortly past noon on Tuesday to be vaccinated. Seeing no line of people waiting, she called her husband to come as well. She said he had originally planned to get his shot today.
"It was excellent. They are so organized and so efficient," Cooper said.
She and her husband had almost no wait, she said. Cooper had brought a book with her, but she didn't have time to read it. She said she hadn't expected there to be so many volunteers.
The clinic had expected 70-100 volunteers at a time. A flu clinic news release today said that 150 people volunteered at the clinic throughout the day.
When Cooper was vaccinated, staff and volunteers, including members of the Havre Fire Department and the Havre Police Department, outnumbered patients. Volunteers helped patients fill out forms, and escorted people to and from their cars, or to shuttles, which carried people between the Fifth Avenue Christian Church and the HRDC building.
Archie Kuka, a 91-year-old Havre resident, said he saw the line of people waiting Tuesday morning and decided to return in the afternoon, hoping for shorter lines. His plan worked.
"I came by this morning and the line was a mile long," he said. "I got right in" just now, he said.
Three representatives from the Montana Department of Health and Human Services observed or assisted the clinic Tuesday.
Kerri Blanton, a program specialist for the state, said she is compiling a training video, using footage from Hill County's clinics, as well as a clinic held in Kalispell and one in Helena. The video will include the best ideas from each location. Blanton said that from what she had seen, Hill County's best ideas were the number of chairs available for people, and the tape on the floor directing people to the next station.
Blanton said Hill County's setup was an improvement over what she had seen in Kalispell, where the clinic had not provided enough chairs, which was particularly difficult for seniors, she added.
Blanton said the Kalispell clinic used a color-coding system for its workers, which consisted of different colored vests, so that nurses, greeters, and other volunteers could be easily identified.
Blanton said Great Falls and Missoula held similar clinics, but several other counties canceled their clinics because of a shortage of doses.
Unlike other counties, Hill County entered the names of people who received a vaccination during the clinic into a database, Blanton said. Hill County is one of nine counties that are participating in a pilot project, using an Internet system to access and add information to the state's immunization registry database. While other counties will have thousands of names to add after the fact, when the doors close today at 5 p.m., Hill County will have most of its work completed, she said.
The clinic "has been a nice opportunity to take a smaller scale situation and give us the opportunity to practice so we can fine tune our emergency response," Northern Montana Hospital spokesperson and clinic volunteer Kathie Newell said. "The community should be reassured."
By 2 p.m. Tuesday, Smith said she had recovered from the morning rush, and was ready and eager to see more visitors.
"People are working hard together. We're ready and waiting, we just need more people to come," she added.
Smith said a few kinks had been worked out throughout the day. Early Tuesday morning, more chairs were brought out to the waiting area where people could sit after receiving a shot. Those who received a vaccination were asked to wait 10-15 minutes at the clinic, to make sure there was no adverse allergic reaction to the shot. Some volunteers were also reshuffled to different areas, to alleviate bottlenecks at some parts of the line, Smith said.
Smith said some people had a minor reaction to the flu shot, including feeling light headed or slightly overheated, which are common reactions to a flu shot, she added. Smith said no serious problems were noted.
Of the 1,026 doses administered Tuesday, 844 went to adults who visited the clinic and 82 were administered to home-bound patients, including 52 to children, throughout the county.
A mobile clinic staffed with a nurse, a secretary, and a student nurse visited homes throughout the day.
One hundred of Tuesday's doses went to children, Brandon said. Children that receive a flu shot must have a follow-up vaccination in a month, which will be provided by the state, she added.
Brandon said the CDC has recently released 11 million more doses of flu vaccine, which may mean more doses available to Hill County.
